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UnityPoint Clinic - Express (North Crossing)

2134 Logan Avenue
Waterloo, IA 50703

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UnityPoint Clinic - Express (San Marnan)

1655 East San Marnan Drive
Waterloo, IA 50702

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UnityPoint Clinic - Express (Viking Road)

1000 Brandilynn Blvd
Cedar Falls, IA 50613

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UnityPoint Clinic - Express (Waverly)

101 Cedar River Pkwy 101
Waverly, IA 50677

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Truck Driver

DOT Physical Exam Requirements

To schedule your DOT physical at Allen Occupational Health, call (319) 266-3127.

This physical is mandated by Federal Motor Carrier Safety Regulations for drivers with a Commercial Drivers License (CDL). The examination should be performed by a qualified professional who will take into account the specific requirements of the transportation industry. A summary of the regulated procedures and protocols is provided on the reverse side of the mandated DOT medical examination form entitled "Physical Examination of Drivers". The CDL driver who is physically qualified to operate a motor vehicle must carry a valid "Medical Examiner's Certificate". A DOT drug screen may be required with the physical exam depending on the type of vehicle driven.

Certification / Recertification Questionnaire

Please provide supportive documents at your appointment for all of the following questions you respond "yes" to.

Drivers may be disqualified, placed on determination pending or given a short period of certification if supportive documents are not available at the time of the examination.

Please note:

  • We are now offering a DOT review of documents to ensure you  have everything you need before your exam. Call our scheduling line at (319) 266-3127 to request this service. An additional $20 fee will be applied.
  • There will be an additional charge for review of supporting documents for drivers placed in the "determination pending" status.

Are you on any medications? Please provide a list of your prescriptions.

Do you have diabetes?

  • Bring Hemoglobin A1C results, drawn within last three months.
  • Bring a note from your PCP stating your blood sugar is controlled on your medications.
  • Are you on insulin? If so, the Insulin Treated Diabetes Mellitus Assessment Form, MCSA-5870 needs to be completed by your Primary Care Provider and returned to us before an examination can be performed.

Do you have a cardiac condition including Stents, Pacemaker or Defibrillator?

  • Bring a note from your cardiologist that states "the patient is safe to drive a commercial motor vehicle"
  • Stents: Bring results of last stress test, if applicable.
  • Coronary artery bypass surgery: Bring results of last stress test, if applicable
  • Pacemaker users: Bring a card indicating what type of pacemaker has been implanted.
  • Defibrillators are an automatic disqualification.

Do you have Sleep Apnea?

  • Bring record of CPAP usage, must be average of greater than 4 hours per night for over 70% of nights.

Do you have a psychiatric condition like depression/anxiety/bipolar disorder or take a sleeping pill?

  • Bring a note from your PCP stating how well your condition is controlled and if you are safe to operate a commercial vehicle.

Have you had a recent surgery (within last year)?

  • Bring a note from your treating physician regarding work restrictions, if any.

Are you on a blood thinner?

  • Bring documentation of your last INR.

Do you require a hearing aid or glasses for your DOT license?

  • Bring corrective eyewear and/or a recent audiogram, performed with your hearing aids. Audiogram should be less than one month old.

Are you currently on disability and/or restrictions? What are your restrictions?

Have you had a stroke or do you have a neurological condition?